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Stenting in Aortic Coarctation at Least Equals Other Methods

Acute procedural success rate is 96 percent; cumulative long-term success rate is 77 percent

FRIDAY, Sept. 17 (HealthDay News) -- The short- and long-term outcomes of stent implantation for aortic coarctation appear comparable or superior to those of other approaches, according to research published in the October issue of Catheterization & Cardiovascular Interventions.

Ralf Holzer, M.D., of Nationwide Children's Hospital in Columbus, Ohio, and colleagues analyzed data from 302 patients with coarctation who underwent stent implantation between 2000 and 2009. The authors defined procedural success as having an upper limb/lower limb systolic gradient of less than 20 mm Hg, lack of significant recurring obstruction, and lack of unplanned repeat intervention.

The researchers found that the acute procedural success was 96 percent. The cumulative intermediate success (three to 18 months) was 86 percent, and cumulative long-term success (more than 18 to 60 months) was 77 percent. Roughly 1 percent of patients had aortic wall complications (dissection in one and aneurysm in three), and 4 percent had unplanned repeat interventions. In addition, 23 percent had systolic blood pressure above the 95th centile at long-term follow-up, while 9 percent had an upper-to-lower limb blood pressure gradient above 20 mm Hg and 32 percent were on antihypertensive drugs. The researchers concluded that the short-, intermediate-, and long-term outcomes of stent implantation were comparable to or better than those of other types of interventions.

"The results of stent implantation compare well with other surgical and interventional series. On the basis of the data of this study, operators should aim for an immediate postprocedural gradient reduction to less than 20 mm Hg," the authors conclude.

A co-author disclosed a financial relationship with NuMED, and the consortium that collected the data has received industry support from companies including NuMED.

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